When is inpatient care for cocaine toxicity indicated?

Updated: Sep 01, 2018
  • Author: Lynn Barkley Burnett, MD, EdD, LLB(c); Chief Editor: Sage W Wiener, MD  more...
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Answer

A brief observation period with 2 blood samples sent for troponin measurement within 9-12 hours is a reasonable approach for low-risk patients with cocaine-related chest pain. Admission is indicated for patients whose chest pain has any of the following characteristics:

  • Severe, sustained, or recurrent
  • Associated with significant cardiac risk factors
  • Associated with any acute cardiopulmonary symptoms
  • Accompanied by positive cardiac markers or ECG changes suggestive of ischemia

Other indications for admission to a critical care unit may include unresolved moderate-to-severe signs and symptoms, including seizures and focal neurologic deficits, and suspected ingestion of packages of cocaine.


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